Question: A newly admitted patient who is acutely psychotic is a private patient of the senior psychiatrist. To whom does the psychiatric nurse who is assigned to this patient owe the duty of care? a. Health care provider b. Profession c. Hospital d. Patient
A newly admitted patient who is acutely psychotic is a private patient of the senior psychiatrist. To whom does the psychiatric nurse who is assigned to this patient owe the duty of care? a. Health care provider b. Profession c. Hospital d. Patient Correct Answer d. Patient
Question: What action by a nurse constitutes a breach of a patient’s right to privacy? a. Asking a family to share information about a patient’s prehospitalization behavior. b. Discussing the patient’s history with other staff members during care planning. c. Documenting the patient’s daily behaviors during hospitalization.
What action by a nurse constitutes a breach of a patient’s right to privacy? a. Asking a family to share information about a patient’s prehospitalization behavior. b. Discussing the patient’s history with other staff members during care planning. c. Documenting the patient’s daily behaviors during hospitalization. d. Releasing unauthorized information to the patient’s employer. Correct Answer d. Releasing unauthorized information to the patient’s employer.
Question: An adolescent hospitalized after a violent outburst tells the nurse, “I’m going to kill my father, but I know you can’t tell anyone.” What is the nurse’s best response? a. “You’re required to share these kinds of thoughts with your psychiatrist.” b. “Those kinds of thoughts will make your hospitalization even longer.”
An adolescent hospitalized after a violent outburst tells the nurse, “I’m going to kill my father, but I know you can’t tell anyone.” What is the nurse’s best response? a. “You’re required to share these kinds of thoughts with your psychiatrist.” b. “Those kinds of thoughts will make your hospitalization even longer.” c. “I am required to share information like this with my treatment team.” d. “I am not required to share these kinds of thoughts with your treatment team.” Correct Answer c. “I am required to share information like this with my treatment team.”
Question: A voluntarily hospitalized patient tells the nurse, “Get me the forms I need to sign so I can leave this place now.” What is the nurse’s best initial response? a. “I can’t give you those forms without your health care provider’s knowledge.” b. “I will get them for you, but let’s talk about your decision to leave treatment.”
A voluntarily hospitalized patient tells the nurse, “Get me the forms I need to sign so I can leave this place now.” What is the nurse’s best initial response? a. “I can’t give you those forms without your health care provider’s knowledge.” b. “I will get them for you, but let’s talk about your decision to leave treatment.” c. “Since you signed your consent for treatment, you may leave if you desire.” d. “I’ll get the forms for you right now and bring them to your room.” Correct Answer b. “I will get them for you, but let’s talk about your decision to leave treatment.”
Question: The family of a patient whose insurance will not pay for continuing hospitalization considers transferring the patient to a public psychiatric hospital. The family expresses concern that the patient will “never get any treatment.” Which reply by the nurse would be most helpful? a. “Under the law, treatment must be provided. Hospitalization without treatment violates patients’ rights.”
The family of a patient whose insurance will not pay for continuing hospitalization considers transferring the patient to a public psychiatric hospital. The family expresses concern that the patient will “never get any treatment.” Which reply by the nurse would be most helpful? a. “Under the law, treatment must be provided. Hospitalization without treatment violates patients’ rights.” b. “That’s a justifiable concern because the right to treatment extends only to the provision of food, shelter, and safety.” c. “Much will depend on other patients’ needs because the right to treatment for a psychotic patient takes precedence over the right to treatment of a patient who is stable.” d. “All patients in public hospitals have the right to choose both a primary therapist and a primary nurse.” Correct Answer a. “Under the law, treatment must be provided. Hospitalization without treatment violates patients’ rights.”
Question: Which individual diagnosed with a mental illness may need emergency or involuntary hospitalization for mental illness? a. The patient who resumes using heroin while still taking methadone. b. The patient who reports hearing angels playing harps during thunderstorms. c. The patient who throws a heavy plate at a waiter at the direction of command hallucinations.
Which individual diagnosed with a mental illness may need emergency or involuntary hospitalization for mental illness? a. The patient who resumes using heroin while still taking methadone. b. The patient who reports hearing angels playing harps during thunderstorms. c. The patient who throws a heavy plate at a waiter at the direction of command hallucinations. d. The patient who does not show up for an outpatient appointment with the mental health nurse. Correct Answer c. The patient who throws a heavy plate at a waiter at the direction of command hallucinations.
Question: A patient being treated in an alcohol rehabilitation unit reveals to the nurse, “I feel terrible guilt for sexually abusing my 6-year-old child before I was admitted.” Based on state and federal law, what action is the nurse expected to take? a. Anonymously report the abuse by telephone to the local child abuse hotline.
A patient being treated in an alcohol rehabilitation unit reveals to the nurse, “I feel terrible guilt for sexually abusing my 6-year-old child before I was admitted.” Based on state and federal law, what action is the nurse expected to take? a. Anonymously report the abuse by telephone to the local child abuse hotline. b. Replying, “I’m glad you feel comfortable talking to me about it.” c. Respecting the nurse–patient relationship of confidentiality. d. Filing a written report on the agency letterhead. Correct Answer a. Anonymously report the abuse by telephone to the local child abuse hotline.
Question: The spouse of a patient who experiences delusions asks the nurse, “Under what circumstances under which the treatment team is justified in violating patient confidentiality?” What is the nurse’s best response? a. “We can’t violate that confidence under any circumstances.” b. “The duty to warn at the discretion of the psychiatrist.”
The spouse of a patient who experiences delusions asks the nurse, “Under what circumstances under which the treatment team is justified in violating patient confidentiality?” What is the nurse’s best response? a. “We can’t violate that confidence under any circumstances.” b. “The duty to warn at the discretion of the psychiatrist.” c. “We can’t do that only at the discretion of the law.” d. “We are required by law to warn the intended victim if there is a clear and present danger.” Correct Answer d. “We are required by law to warn the intended victim if there is a clear and present danger.”
Question: A nurse cares for an older adult patient admitted for treatment of depression. The health care provider prescribes an antidepressant medication, but the dose is more than the usual adult dose. The nurse is obligated to take what action? a. Implement the order as written but document the concern. b. Hold the medication and then notify the health care provider.
A nurse cares for an older adult patient admitted for treatment of depression. The health care provider prescribes an antidepressant medication, but the dose is more than the usual adult dose. The nurse is obligated to take what action? a. Implement the order as written but document the concern. b. Hold the medication and then notify the health care provider. c. Consult a drug reference if a pharmacist is not available. d. Give the usual geriatric dosage at the scheduled times. Correct Answer b. Hold the medication and then notify the health care provider.
Question: A patient diagnosed with schizophrenia believes evil spirits are being summoned by a local minister and verbally threatens to bomb a local church. What principle governs the proper action in this situation? a. Need for authorization b. Duty to warn and protect c. Patient right to confidentiality d. Patient’s right to self-actualization
A patient diagnosed with schizophrenia believes evil spirits are being summoned by a local minister and verbally threatens to bomb a local church. What principle governs the proper action in this situation? a. Need for authorization b. Duty to warn and protect c. Patient right to confidentiality d. Patient’s right to self-actualization Correct Answer B
Question: After receiving an order for a stat medication, the charge nurse gives the medication to a patient and asks a staff nurse, “Please document the administration of the medication for me. My password is nurse2. What action should the on-duty nurse take? a. Suggest the nurse return and document. b. Refer the matter to the charge nurse to resolve.
After receiving an order for a stat medication, the charge nurse gives the medication to a patient and asks a staff nurse, “Please document the administration of the medication for me. My password is nurse2. What action should the on-duty nurse take? a. Suggest the nurse return and document. b. Refer the matter to the charge nurse to resolve. c. Access the record and document the information. d. Report the request to the patient’s health care provider. Correct Answer B
Question: A patient diagnosed with mental illness asks a psychiatric technician, “What’s the matter with me?” The technician replies, “Your wiring nuts need tightening.” The nurse who overheard the exchange should take action based on what principle? a. Violation of the patient’s right to be treated with dignity and respect
A patient diagnosed with mental illness asks a psychiatric technician, “What’s the matter with me?” The technician replies, “Your wiring nuts need tightening.” The nurse who overheard the exchange should take action based on what principle? a. Violation of the patient’s right to be treated with dignity and respect b. The nurse’s obligation to report coworker negligence c. Preventing defamation of the patient’s character d. Supervisory liability Correct Answer A
Question: Which documentation of a patient’s behavior best demonstrates a nurse’s observations? a. Isolates self from others. Frequently fell asleep during group. Vital signs stable. b. Calmer and more cooperative. Participated actively in group. No evidence of psychotic thinking. c. Appeared to hallucinate. Patient frequently increased volume on television, causing conflict with others.
Which documentation of a patient’s behavior best demonstrates a nurse’s observations? a. Isolates self from others. Frequently fell asleep during group. Vital signs stable. b. Calmer and more cooperative. Participated actively in group. No evidence of psychotic thinking. c. Appeared to hallucinate. Patient frequently increased volume on television, causing conflict with others. d. Wears four layers of clothing. States, “I need protection from dangerous bacteria trying to penetrate my skin.” Correct Answer D
Question: A nurse volunteers for a committee that must revise the hospital policies and procedures for suicide precautions. Which resources would provide the best guidance? (Select all that apply.) a. Diagnostic and Statistical Manual of Mental Disorders (fifth edition) (DSM-5) b. State’s nurse practice act c. State and federal regulations that govern hospitals
A nurse volunteers for a committee that must revise the hospital policies and procedures for suicide precautions. Which resources would provide the best guidance? (Select all that apply.) a. Diagnostic and Statistical Manual of Mental Disorders (fifth edition) (DSM-5) b. State’s nurse practice act c. State and federal regulations that govern hospitals d. Summary of common practices of several local hospitals e. American Nurses Association Scope and Standards of Practice Correct Answer C, E
Question: In which situations does a nurse have a duty to intervene and report? (Select all that apply.) a. A peer is unable to write behavioral outcomes. b. A health care provider consults the Physicians’ Desk Reference. c. A peer tries to provide patient care in an alcohol-impaired state. d. A team member has violated the boundaries of a vulnerable patient.
In which situations does a nurse have a duty to intervene and report? (Select all that apply.) a. A peer is unable to write behavioral outcomes. b. A health care provider consults the Physicians’ Desk Reference. c. A peer tries to provide patient care in an alcohol-impaired state. d. A team member has violated the boundaries of a vulnerable patient. e. A patient refuses a medication prescribed by a licensed health care provider. Correct Answer C, D
Question: Which situations qualify as abandonment on the part of a nurse? (Select all that apply.) a. The nurse allows a patient with acute mania to refuse hospitalization without taking further action. b. The nurse terminates employment without referring a seriously mentally ill patient for aftercare. c. The nurse calls police to bring a suicidal patient to the hospital after a suicide attempt.
Which situations qualify as abandonment on the part of a nurse? (Select all that apply.) a. The nurse allows a patient with acute mania to refuse hospitalization without taking further action. b. The nurse terminates employment without referring a seriously mentally ill patient for aftercare. c. The nurse calls police to bring a suicidal patient to the hospital after a suicide attempt. d. The nurse refers a patient with persistent paranoid schizophrenia to community treatment. e. The nurse asks another nurse to provide a patient’s care because of concerns about countertransference. Correct Answer A, B
Question: A new staff nurse completes orientation to the psychiatric unit. This nurse will expect to ask an advanced practice nurse to perform which action for patients? a. Perform mental health assessment interviews. b. Establish therapeutic relationships. c. Prescribe psychotropic medication. d. Individualize nursing care plans.
A new staff nurse completes orientation to the psychiatric unit. This nurse will expect to ask an advanced practice nurse to perform which action for patients? a. Perform mental health assessment interviews. b. Establish therapeutic relationships. c. Prescribe psychotropic medication. d. Individualize nursing care plans. Correct Answer C
Question: A newly admitted patient diagnosed with major depressive disorder has lost 20 pounds over the past month and has admitted having suicidal ideations. The patient has taken an antidepressant medication for 1 week without remission of symptoms. Select the priority nursing diagnosis. a. Imbalanced nutrition: Less than body requirements
A newly admitted patient diagnosed with major depressive disorder has lost 20 pounds over the past month and has admitted having suicidal ideations. The patient has taken an antidepressant medication for 1 week without remission of symptoms. Select the priority nursing diagnosis. a. Imbalanced nutrition: Less than body requirements b. Chronic low self-esteem c. Risk for suicide d. Hopelessness Correct Answer C
Question: A patient diagnosed with major depressive disorder has lost 20 pounds in 1 month. The patient has chronic low self-esteem and a plan for suicide. The patient has taken an antidepressant medication for 1 week. Which nursing intervention is most directly related to this priority: “Patient will refrain from gestures and attempts to harm self”?
A patient diagnosed with major depressive disorder has lost 20 pounds in 1 month. The patient has chronic low self-esteem and a plan for suicide. The patient has taken an antidepressant medication for 1 week. Which nursing intervention is most directly related to this priority: “Patient will refrain from gestures and attempts to harm self”? a. Implement suicide prevention interventions. b. Frequently offer high-calorie snacks and fluids. c. Assist the patient to identify three personal strengths. d. Observe patient for therapeutic effects of antidepressant medication. Correct Answer A